A review of the literature reveals that tibial adamantinoma is a very rare lesion. Only ten cases have been recorded, with one additional adamantinoma-like tumor by Richter. The case reported by the author is the eleventh. Although two theories have been advanced with respect to the etiology of this growth, we do not have sufficient clinical data to substantiate either hypothesis. Clinical and roentgenographic examinations are insufficient for establishing a diagnosis. Even on histological examination the diagnosis is not clear-cut, as is shown in the author's case and in the other reported cases. Adamantinoma is a slow-growing tumor, which does not metastasize, but recurs unless completely removed. The time of recurrence varies from a few months to several years. The writer believes that, if the growth is not too extensive, it can be removed completely at the first operation by radical saucerization and curettement. If a second operation is necessary, the operation herewith described, which has been used with apparent success in this case, is certainly superior to an amputation.